Transfusion Technology Assessment
PI: Mart Janssen PhD
The joint Sanquin – Julius Center Transfusion Technology Assessment (TTA) unit, established in 2003, is an ongoing collaboration of Sanquin Blood Supply Foundation and the Medical Technology Assessment department of the Julius Center for Health Sciences and Primary Care at Utrecht University. The unit was installed with the mission to provide scientific evidence to support informed decision making by Sanquin management and national and international policymakers based on statistical and mathematical modeling. Since its conception, TTA has performed various risk assessments and economic evaluations concerning blood safety. TTA has also established models for clinical blood use, blood recipient profiles and collected and analyzed European data on blood use and supply. The TTA unit produces scientific publications, but also proprietary information to Sanquin Executive Board and Sanquin Plasma Products division. In the past years, in the course of the PROTON study, TTA has compiled an invaluable source of information on the blood transfusion chain (BTC) that is unique for the Netherlands and rare in the world. Since its establishment, the TTA group has been among the few groups worldwide to be involved in similar issues. TTA group members have been invited to share their expertise by organizations such as the European Medicines Agency, the Council of Europe (EDQM) and the International Society for Blood Transfusion.
The main focus of TTA is on the following topics:
Optimal Blood Safety
Blood products are very safe, but remain derived from human origin, the donors of which are exposed to changing environments. Emerging infectious diseases (EID) may require changes to existing, or implementation of new safety interventions. Also, newly identified non-infectious risks for recipients, like for example the shelf life of blood products, may require new approaches. Risks of negative health outcomes for recipients of blood need to be assessed on a regular basis. Dutch government policy is to aim at ‘optimal blood safety’. This concept of optimal blood safety becomes increasingly acknowledged worldwide, although it is not well defined (yet). Within a context of high costs for infection prevention, cost-utility analyses provide tools to support rational decision making for (new) safety interventions.
Optimal Blood Use
Modeling recipient outcomes requires national data on clinical blood use and blood recipient profiles, including recipient gender, age, underlying disease and survival after transfusion. In collaboration with hospitals and the Statistics Netherlands (CBS), datasets are maintained on the use of blood products to different categories of recipients and on recipient morbidity and mortality. In addition the characteristics of local blood use can be used for benchmarking and hypothesis generation. European data collection and analyses for the Council of Europe elaborated by TTA provides additional comparisons and insight in trends at European level.
Optimal Blood supply
Aging of donors may diminish the provision of the blood supply and conversely aging of recipients may increase the demand. Donor population and collection characteristics need to be modeled based on various available datasets. Blood use needs to be analyzed from hospital datasets in order to signal trends in blood use for various patient groups. Ongoing monitoring and statistical modeling of changes herein allows Sanquin’s blood supply management to be timely informed on trends in supply of and demand for blood.
Application of modeling methods in the past reveals that in some cases existing methods require adaptation or that these can be improved or further developed. Methodology developments are primarily initiated for problem solving within the primary TTA objectives, and when appropriate, submitted for publication in relevant journals. Development of new methodological approaches is essential to remain on the forefront of transfusion technology assessment research.
At this moment there are no internships available at the department of Transfusion Technology Assessment.